Graft-Versus-Host Disease in Children Who Have Received a Cord-Blood or Bone Marrow Transplant from an HLA-Identical Sibling

Abstract

Recipients of cord-blood transplants from HLA-identical siblings have a lower incidence of acute and chronic GVHD than recipients of bone marrow transplants from HLA-identical siblings.

Mesenchymal Stem Cells for Severe Intraventricular Hemorrhage in Preterm Infants: Phase I Dose-Escalation Clinical Trial

“…Allogeneic transplantation of MSCs may have a logistic advantage because they are ready to use “off the shelf” in the clinical setting. Moreover, UCB‐derived MSCs exhibit several advantages over adult tissue‐derived MSCs including lower immunogenicity 16, 36 and higher proliferation capacity, paracrine potency, and therapeutic efficacy both in vitro 17, 18 and in vivo 37. These MSCs show karyotypic stability and no senescence up to the 11th passage.…”

“…Human umbilical cord blood (UCB) is a promising source of MSCs. In comparison to adult tissue‐derived MSCs, its advantages include easier extraction, lower immunogenicity 16, higher in vitro proliferation capacity 17, 18, and better in vivo therapeutic efficacy 19. Recently, we have shown that xenotransplantation of human UCB‐derived MSCs significantly attenuates brain injury and the progress of PHH after severe IVH in immunocompetent newborn rats 15, 20, 21.…”

Outcome following unrelated cord blood transplant in 136 patients with malignant and non-malignant diseases: a report from the Australian and New Zealand children's haematology and oncology group

“…[1][2][3][4][5][6][7] Unrelated UCB has been used successfully for patients with a range of malignant and non-malignant diseases including leukaemia and lymphoma, constitutional and acquired BM failure syndromes, severe congenital immunodeficiency syndromes, haemoglobinopathies and selected metabolic disorders. [1][2][3][4]6,[8][9][10][11] It has been estimated that more than 95% of patients are able to find at least one potential 4 of 6 HLA matched cord blood unit on the National Marrow Donor Registry, with the majority finding a potential five of six match.…”

“…[1][2][3][4][5][6][7] Unrelated UCB has been used successfully for patients with a range of malignant and non-malignant diseases including leukaemia and lymphoma, constitutional and acquired BM failure syndromes, severe congenital immunodeficiency syndromes, haemoglobinopathies and selected metabolic disorders. [1][2][3][4]6,[8][9][10][11] It has been estimated that more than 95% of patients are able to find at least one potential 4 of 6 HLA matched cord blood unit on the National Marrow Donor Registry, with the majority finding a potential five of six match. 12 The known advantages of unrelated UCB over unrelated BM are well documented and include increased speed of availability, 13 absence of risk to the donor, reduced transmission of viral illnesses such as CMV, tolerance of HLA disparity between the donor and recipient, 9,14,15 better minority representation in UCB banks and reduced risk and severity of acute GVHD when compared to BM grafts.…”

“…12 The known advantages of unrelated UCB over unrelated BM are well documented and include increased speed of availability, 13 absence of risk to the donor, reduced transmission of viral illnesses such as CMV, tolerance of HLA disparity between the donor and recipient, 9,14,15 better minority representation in UCB banks and reduced risk and severity of acute GVHD when compared to BM grafts. 1,2,[4][5][6]9,10,14,16,17 When compared to BM, however, cord blood results in less optimal engraftment kinetics with higher rate of graft failure and slower haematopoietic recovery time. 10,[18][19][20][21][22] Recent reports suggest that unrelated UCB transplants now account for 20% of all allogeneic transplantations performed in young patients less than 20 years of age.…”